Within a week, perhaps a day before or a few days later, India will have one million active cases of the coronavirus disease. It will become the second country in the world after the US to have active cases over a million; The US has about 2.5 million active cases today (the highest it has ever had). Brazil, which has seen more cases than India, has never exceeded 820,000 active cases. At the current rate, India will overtake Brazil early next week to become the second country with the highest number of cases.
The number of daily new Covid-19 cases in the US and Brazil is off its peaks; India’s daily count continues to rise. Some states are not testing enough yet, so it is not known when India could peak, or what that peak will be: 100,000? 120,000? Any number would be a guess. India ended Friday with 87,691 new cases, bringing its total number of cases to 4,016,037 and the number of active cases to 844,396. The country recorded 1,056 deaths on Friday. On average, since Monday, it has recorded 1,001 deaths a day. Its fatality rate, based on Friday night figures, may be 1.7%, but in absolute terms, an average of 1,001 deaths a day is concerning. With this death rate, new cases on Friday could result in 1,517 deaths, and that’s not a small number, either.
These are depressing numbers to wake up to on a Saturday morning, but this is the situation India is in, and a strict mindset won’t help.
- Aggressively test and set targets for states
- Work with pharmaceutical companies to develop accurate antigen tests.
- Review the healthcare infrastructure in the interior states
- Enforce social distancing, wearing masks, and banning public events.
- Evaluate the costs and benefits of opening.
Maharashtra, which along with Delhi and Tamil Nadu was among the first hot spots for the disease, remains one of them, accounting for around a fifth of daily cases in India on average. Tamil Nadu has been on a long plateau for months. And Delhi, which saw a sharp decline in cases, followed by a slight reduction in testing, is now seeing an increase in cases as the local administration becomes more aggressive with testing. It’s too early to tell, but the capital may settle on the kind of long plateau that Tamil Nadu is seeing. Warning: Anecdotal evidence suggests that at least some of the cases seen in Delhi are from patients from neighboring states (and the interior) heading directly to the capital’s top medical facilities. Meanwhile, cases in other states of the peninsula and the interior continue to increase.
Six months to a day after the first local cases were recorded in India (in Delhi in early March), it is clear that no Indian state can claim to have defeated the virus. Kerala’s early claims were more of a publicity campaign than anything else, and Delhi’s rejoicing in early August proved premature.
- Within a week, India will become the second country in the world after the United States to have active cases above a million. At the current rate, India will also overtake Brazil early next week to become the second country with the highest number of cases. The number of new daily cases in the US and Brazil is off its peaks; and India’s daily count continues to rise. It is not known when India could peak, or what that peak will be.
While India is going through four million cases, this is the situation it is in. There is no certainty that a vaccine will be found before the end of the year and will be available for India. The country should work on the supply, distribution and administration of the vaccine, but be prepared for the eventuality that it is not available before the end of 2021. And there is no certainty that India will achieve herd immunity. Serological surveys (blood tests for antibodies) are a good way to assess the prevalence of the disease, but high (or moderate) exposure levels should not make administrations complacent.
This is the 150th installment of this column, so I’ll end with five things that I think India should do now.
First, you should conduct tests extensively and aggressively, set targets for states, and insist that unless time is a constraint, only molecular tests like RT-PCR be used.
Two, you should work with drug companies to develop rapid antigen tests that are accurate (such as the new one from Abbott Laboratories, released in the US), or other tests (such as the Institute for Genetics and Integrative Biology’s spectroscopic test on the one HT wrote earlier this week) that can be installed in offices, airports and train stations, and other public areas for quick and accurate testing.
Third, it should review the healthcare infrastructure, especially hospital beds with oxygen facilities and ventilators in the interior states, which will see an increase in the coming months.
Fourth, it should enforce social distancing, wearing masks, and banning all public events (even 50 people is too large a group).
Fifth, you need to carefully assess the costs and benefits of opening up, especially recreational facilities, public transportation, and schools (when India crossed a million cases, on July 16, this column recommended that the government work to provide every school-age child in need, a device – there has been no movement in this).
The virus is still at large and is spreading. And there is still no cure for that.
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